Purpose of Review

Symptomatic lumbar spinal stenosis (LSS) is a condition affecting a growing number of individuals resulting in significant disability and pain. Traditionally, treatment options have consisted of conservative measures such as physical therapy, medication management, epidural injections and percutaneous adhesiolysis, or surgery. There exists a treatment gap for patients failing conservative measures who are not candidates for surgery. Minimally invasive lumbar decompression (MILD®) and interspinous process device (IPD) with Superion® represent minimally invasive novel treatment options that may help fill this gap in management. We performed a literature review to separately evaluate these procedures and assess the effectiveness and safety.

Recent Findings

The available evidence for MILD and Superion has been continuously debated. Overall, it is considered that while the procedures are safe, there is only modest evidence for effectiveness.

Summary

For both procedures, we have reviewed 13 studies. Based on the available evidence, MILD and Superion are safe and modestly effective minimally invasive procedures for patients with symptomatic LSS. It is our recommendation that these procedures may be incorporated as part of the continuum of treatment options for patients meeting clinical criteria.

中文翻译：

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微创腰椎减压和棘突间装置治疗有症状的腰椎管狭窄症：文献综述。

审查目的

有症状的腰椎管狭窄症（LSS）是一种影响越来越多的个体的疾病，导致严重的残疾和疼痛。传统上，治疗选择包括保守措施，例如物理疗法，药物管理，硬膜外注射和经皮粘连溶解或手术。对于未通过保守治疗但不能接受手术治疗的患者，存在治疗差距。带有Superion®的微创腰椎减压（MILD®）和棘突间器械（IPD）代表了微创新型治疗方案，可帮助填补这一管理空白。我们进行了文献综述，以分别评估这些程序并评估有效性和安全性。

最近的发现

有关MILD和Superion的可用证据一直在争论不休。总体而言，人们认为尽管程序安全，但仅有很少的证据证明其有效性。

概要

对于这两种程序，我们已经审查了13项研究。根据现有证据，对于有症状的LSS患者，MILD和Superion是安全且适度有效的微创手术。我们建议对于符合临床标准的患者，可以将这些程序作为治疗方案的一部分。